特殊脂蛋白组分及亚组分与NAFLD严重程度的关系

Relationship between Special Lipoprotein Components and Subcomponents and the Severity of NAFLD

目的:探讨特殊脂蛋白组分及亚组分与非酒精性脂肪性肝病(NAFLD)严重程度的关系。方法:选取2020年1月—2022年7月佛山复星禅诚医院收治的140例NAFLD患者作为NAFLD组,选取同期健康体检者100例作为对照组。根据NAFLD严重程度将NAFLD组分为轻度组(60例),中度组(40例),重度组(40例)。检测所有研究对象特殊脂蛋白组分及亚组分水平。比较NAFLD组和对照组特殊脂蛋白组分及亚组分水平。比较轻度组、中度组、重度组特殊脂蛋白组分及亚组分水平。分析特殊脂蛋白组分及亚组分水平与NAFLD严重程度的关系。结果:NAFLD组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、非高密度脂蛋白胆固醇(non-HDL-C)、低密度脂蛋白颗粒(LDL-P)、低密度脂蛋白(LDL)、中间密度脂蛋白(IDL)、极低密度脂蛋白(VLDL)、极低密度脂蛋白3(VLDL3)、脂蛋白残粒(RLP)、葡萄糖(GLU)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转移酶(GGT)、血尿素氮(BUN)、尿酸(UA)均显著高于对照组,高密度脂蛋白胆固醇(HDL-C)、高密度脂蛋白2(HDL2)、高密度脂蛋白3(HDL3)均显著低于对照组,差异有统计学意义(P<0.05)。中度组TC、TG、non-HDL-C、LDL-P、LDL、IDL、VLDL3、RLP均高于轻度组,HDL2低于轻度组;重度组TC、TG、LDL-C、non-HDL-C、LDL-P、LDL、IDL、VLDL、VLDL3、RLP均高于轻度组,HDL-C、HDL2、HDL3均低于轻度组;重度组TC、TG、LDL-C、non-HDL-C、LDL、IDL、VLDL、RLP均高于中度组,HDL2低于中度组,差异有统计学意义(P<0.05)。Spearman相关性分析研究结果显示,TC、LDL-C、non-HDL-C、LDL-P、LDL、IDL、RLP与NAFLD严重程度均呈正相关(P<0.05)。结论:NAFLD患者普遍存在血脂脂蛋白组分及亚组分代谢异常,血清TC、LDL-C、non-HDL-C、LDL-P、LDL、IDL、RLP与疾病严重程度密切相关。

Objective:To investigate the relationship between special lipoprotein components and subcomponents and the severity of non-alcoholic fatty liver disease(NAFLD).Method:A total of 140 patients with NAFLD admitted to Foshan Fosun Chancheng Hospital from January 2020 to July 2022 were selected as the NAFLD group,and 100 health examiner during the same period were selected as the control group.According to the severity of NAFLD,the NAFLD group was divided into mild group(60 cases),moderate group(40 cases)and severe group(40 cases).The levels of specific lipoprotein components and subcomponents were detected in all subjects.The levels of special lipoprotein components and subcomponents in NAFLD group and control group were compared.The levels of special lipoprotein components and subcomponents in mild group,moderate group and severe group were compared.The relationship between the level of special lipoprotein components and subcomponents and the severity of NAFLD was analyzed.Result:Total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C),non-high-density lipoprotein cholesterol(non-HDL-C),low density lipoprotein particles(LDL-P),low density lipoprotein(LDL),intermediate density lipoprotein(IDL),very low density lipoprotein(VLDL),and very low density lipoprotein 3(VLDL3),remnant lipoprotein particles(RLP),glucose(GLU),alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyltransferase(GGT),blood urea nitrogen(BUN)and uric acid(UA)in NAFLD group were significantly higher than those in control group,high density lipoprotein cholesterol(HDL-C),high density lipoprotein 2(HDL2)and high density lipoprotein 3(HDL3)were significantly lower than those in control group,the differences were statistically significant(P<0.05).TC,TG,non-HDL-C,LDL-P,LDL,IDL,VLDL3,RLP in the moderate group were higher than those in the mild group,while HDL2 was lower than that in the mild group;the TC,TG,LDL-C,non-HDL-C,LDL-P,LDL,IDL,VLDL,VLDL3,and RLP in the severe group were higher than those in the mild group,while HDL-C,HDL2,and HDL3 were lower than those in the mild group;the TC,TG,LDL-C,non-HDL-C,LDL,IDL,VLDL,and RLP in the severe group were higher than those in the moderate group,while HDL2 was lower than that in the moderate group,the differences were statistically significant(P<0.05).Spearman correlation analysis showed that TC,LDL-C,non-HDL-C,LDL-P,LDL,IDL,RLP were all positively correlated with the severity of NAFLD(P<0.05).Conclusion:Abnormal metabolism of lipid lipoprotein components and subcomponents is common in NAFLD patients,and serum TC,LDL-C,non-HDL-C,LDL-P,LDL,IDL and RLP are closely related to the severity of the disease.